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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18663
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I have had upper back, between shoulder blade and spine.

Customer Question

I have had upper back, between shoulder blade and spine. This has been constant for many years now without being able to find out cause or treatment. Pain is 24/7 and it impacts sleep quality and quality of life. Year by year I shy away from more and more activities due to this pain. The pain is stabbing and aching. Feels like I have a spiked golf ball under shoulder blade. It also makes my shoulder joint, elbow joint and wrist/fingers arch at times.
XRAYS show nothing wrong.
MRI shows nothing wrong.
Nerve conductivity in arm to fingers shows normal on one side and very slight drop in other, so not carpal tunnel.
Blood tests show elevated inflammation markers but nothing else.
Massage (2x week deep tissue) seemed to help only for hour or two after the massage.
PT doesn't seem to help any more than stretching at home.. if it helps.. only for very short times.. hour or so.
chiropractor visits don't help at all.
Possible causes, my hobby and work is computer use... some days are very long. This may be the cause however, even being away from computer use for weeks or month at a time doesn't help. To Sleep I must hug a big pillow and sleep only on my side. Even with this I wake up to flip sides due to pain about 5-10 times a night.
Please ANY ideas are EXTREMELY appreciated.
Submitted: 6 years ago.
Category: Medical
Expert:  Dr. D. Love replied 6 years ago.

I'm sorry that you are having so much trouble.

It will help if you could provide some further information.

What inflammation markers were elevated? Do you know the results?

What specialists have you seen for this?

Customer: replied 6 years ago.
The blood test was 4-5 years ago and was done to check for many things as the doctor thought I may be diabetic -- overweight at about 220lbs at 5'9". The tests were negative for the things they tested for but I was told there were signs of inflamation and was asked if I had an infected cut, pulled muscles, been working out. They ordered an MRI. The MRI came back clean.
I have seen specialists for back, hands, and also general doctors over the years. This issue has been gradually getting worse over the last 12-15 years. I would guess I have lost 30-50% strength in my hands which seems related. My right side is worse than left. I an left handed. The pain between shoulder blades is usually on the right side, but sometimes on the left.
Expert:  Dr. D. Love replied 6 years ago.

I assume that you saw a Neurologist to perform the nerve conduction studies, correct?

Have you seen a Rheumatologist?

Customer: replied 6 years ago.
I did see both. The Neurologist did the nerve conduction tests. The other I think I left with a pain killer that didn't help.. it was years ago.
I've all but given up on traditional medical avenues... that said I haven't found any help with chiropractic, acupuncture, or other less mainstream solutions either. I've even tried cutting out many parts of diet assuming allergy/inflammation causes, again without any luck. I've suspected weight... and lost 45 lbs and exercise for a 6 month period without any relief.
Expert:  Dr. D. Love replied 6 years ago.

Thank you for the additional information.

It is frustrating when someone is having persistent symptoms that cannot be well explained. The most common cause of pain such as you describe is fibromyalgia. The fibromyalgia can cause diffuse muscle pain that frequently involves the muscles around the shoulder blade, but can affect many different muscles. The pain also typically interferes with sleep, which tends to make the problem worse, as the muscles never get he restorative sleep at the end of each day. The blood tests and x-rays are consistently normal in persons with fibromyalgia, although fibromyalgia can occur at the same time as other conditions that may have abnormal blood tests and x-rays. The diagnosis of fibromyalgia is based on the findings on clinical examination, although it may require the specialized assessment of a Rheumatologist. A Rheumatologist would also be the specialist that would best be able to interpret the blood tests that were signs of inflammation. If it has been years since the blood tests were done and that you have seen a Rheumatologist, then that would be the appropriate next step. The other consideration whenever someone as a condition that cannot be explained would be to be seen at a teaching/research hospital, which has more experience in evaluating someone with rare and unusual conditions. Your primary care doctor should be able to assist you in making an appointment.

Customer: replied 6 years ago.
I am familiar with and have read a lot about fibromyalgia seeing researching my symptoms finds this "syndrome". However... I am extremely frustrated when a term such as this is used as possible diagnosis. It is yet another "syndrome"... seemingly another way of saying "I have no idea whats wrong but at least we will give it a name to make you feel diagnosed".
Having read a lot about people diagnosed with this "syndrome", there is very little that routinely helps and largely points to 'live with it.. and take some pain meds when it gets bad'. Volunteering to be a lab-rat at a teaching/research hosptital isn't very appealing. As much as I would like to figure out the cause and mostly a solution to the problem, I have wasted years worth of doctor visits and $$$$ chasing medical answers and am very reluctant to continue doing so unless I have something more to go on than a "syndrome" or lottery chance of being a lab-rat that is helped (instead od time wasted and drugged to cover up symptoms).
I apologize if the above sounds like an insult as it isn't meant to be. I'm just a frustrated person who has spent years jumping through medical industry hoops to get nowhere and have spent too much money in the process just to end up back where I started.
Expert:  Dr. D. Love replied 6 years ago.

I understand your frustration, but I'm trying to help you come to an answer. You can choose to see whomever you like, but being seen at a teaching/research hospital is useful for persons with problems that cannot be explained. You would not be involved in research or in anyway treated as a guinea pig to be seen for an evaluation. If there is any consideration of research, that would be a separate issue and would only be performed with your consent.

Customer: replied 6 years ago.
Relist: Incomplete answer.
fibromyangia isn't a diagnosis but a term put on the lack of a diagnosis. I refuse to believe in a diagnosis whos symptoms are anything and everything you want them to be, has no real causes nor real treatments.
Expert:  Dr. D. Love replied 6 years ago.

It is impossible to make a diagnosis over the internet. I am only trying to offer possibilities of what may be present. Fibromyalgia is a clinical diagnosis, but that does not mean that it is not a diagnosis. If you feel that you have something other than fibromyalgia, it would be appropriate to see a Rheumatologist, who would be best able to assess your symptoms, including your blood tests of inflammation, and determine the cause of your symptoms.

Customer: replied 6 years ago.
Having seen dozens of doctors over 10-15 year period for this issue, I'm not looking for a recommendation to go see more doctors.
I am looking for practical suggestions of what to try or what I/doctors could have missed when looking into the problem. You say it is impossible to make a diagnosis over the internet.. I don't care the name put on the problem.. I call it "Pain between shoulders, lack of sleep, sucks to live without a ifx", you call it fibromyalgia, etc. Let's step past that and look at things worth trying that I haven't exhausted already.
Expert:  Dr. D. Love replied 6 years ago.

Proper treatment is largely dependent upon making a proper diagnosis. However, there are several treatments that have been used in chronic pain from a variety of causes, including certain anti-depressants, such as amitriptyline, nortriptyline, or duloxetine, or anti-seizure medicines, such as gabapentin or pregabalin. These medicine appear to work by interfering with the nerve that is carrying the pain message.

Customer: replied 6 years ago.
Relist: Other.
want a refund.. answer was worthless